Sunday, June 07, 2009

Propagandize this: Health care for all. Now.

The 20th century has been characterized by three developments of great political importance: The growth of democracy, the growth of corporate power, and the growth of corporate propaganda as a means of protecting corporate power against democracy.

-- the late Australian social scientist Alex Carey

This article was published last year, when Secretary of State Hillary Clinton (then a candidate for the presidency) was proposing a system of allowing the private, for-profit health insurance companies to work together to cover everyone (?) rather than scrap it all and build us, from the ground up, a powerful, comprehensive, nationalized system like the ones they have in other developed (and even some undeveloped) countries. Jake at Whiskeyfire writes:

The truth is that large government run programs such as social security are models of efficiency. We have the data and proof. At any rate they couldn't be less efficient than the private health insurance industry. Many estimates of the waste inherent in the private healthcare industry run in excess of 1 trillion dollars annually. There is the answer to that question about where we might find a trillion dollars a year to finance this venture.

We should not forget as we wind our way through this debate about dollars, medical records, reimbursement rates, economies of scale and the like that real people are suffering every day at the hands of people who are willing to sacrifice the health of their fellow men and women for a bit more money. Let me just say that this is what evil looks like and if there is a hell this would consign one to the lower levels in my estimation. If your work causes people to suffer that is evil and your soul is corroding as quickly as your wallet is growing.

Under President Obama, the current reform plan under review is, let's face it, a diluted, hybridized, private-public version; it's far from the socialized medicine model many of us lefties believe is the fairest, most efficient, most cost-effective, and most humane way to care for the health and well-being of our citizens. Even so, the currently-discussed "plan" has obviously got Big Insurance, along with its PR firms and personal handmaids supporters in Congress--Ben Nelson, cough cough--in a tizzy. Big Insurance doesn't want us to have any public option at all. Because then, they will have to compete with an entity that actually provides access to health care. (What, you thought health care insurers were in it for the rewarding, patriotic, humanitarian aspects of providing access to health care for Americans?)

And for some reason, what Big Insurance wants is getting plenty of traction, when in fact there are, what, a couple of hundred million of us and a relatively small number of them?

Democracy? Now?

The statistics laid out herein, alone, demonstrate that the bullshit we're already being bombarded with courtesy of Big Insurance--Oh, but Americans will lose their ability to make choices! Americans don't want to have health care rationed! Americans don't want to be on waiting lists!--is exactly that: bullshit.

Restriction of choices. Rationing. Waiting lists. Those of us who've sat through even a single semester of PR or advertising will immediately recognize these as negative transfer words, sledgehammers in any propaganda-writer's arsenal. They're words (oftentimes they're images) with widely-recognized positive--or, as in this case, negative--associations. And you plaster them all over the thing onto which you want to transfer the previously-established positive or negative reaction. Hence, if you want to make a politician look good, you place lots of flags, smiling children, and green rolling hills in his television spot, since people already react positively to flags, smiling children, and green rolling hills--in pretty much any context.

Correspondingly, if you want to make a policy proposal look bad, you recycle the same negative associations with worst-case-scenario tales from abroad--disingenuous, out-of-context, and even outright false though they may be--that were instrumental in deep-sixing said policy the last time around. Restriction of choices. Rationing. Waiting lists.

I'm just amazed they haven't resurrected Harry and Louise. (Or dug them up, since I don't remember them ever getting the coverage or the health care they talked about needing, so perhaps their stories ended as tragically as have the stories of so many Americans.)

Make no mistake: the companies fling that bullshit at us because they do not want Americans to think about the long wait-times and restriction of choices they already endure, even with top-drawer PPO health coverage: three or four weeks for a simple appointment at the pediatrician's; six months to see a psychologist or gastroenterologist (and if you don't have private insurance, forget about seeing those specialists altogether, because the first question the receptionist will ask, when you call, is not "What's wrong?" or "How may we help you?" but rather, "Who is your insurer?"); the "choice" of paying for vital but non-formulary (and thus exorbitantly expensive) prescription medicine instead of taking care of car-repairs or, heaven forbid, buying something to eat other than lentils and rice that month. They do not want Americans to consider the fact that "elective" surgery--i.e. having cataracts removed so that one can, you know, see properly, which is considered elective or optional surgery by many policies including Medicare--can cost an American tens of thousands of dollars out-of-pocket.

Or just bankrupt him completely: as reported everywhere this week, there are serious financial meltdowns going on within families around the country when someone falls ill or has a serious accident, which are things that can and do happen to us all, every single day. More than 60% of bankruptcies in the United States are caused by a health care crisis. Not frivolous spending or mismanagement of income or living above one's means. A health care crisis.

In other words, whereas some citizens of the world have free*, fully-accessible medical care, well-care, prescription medicine, and emergency care--plus the security of being able to live their lives, do their work, and engage in sports and exercise without the crushing worry that an illness or accident will strip them and their families of everything they own and have worked for--AND whereas those citizens might sometimes have to wait for non-emergent surgery like cataract removal (although that, too, will still be paid for by the state when it comes time for the surgery)--something not unlike the wait period that even the best-insured American, save perhaps the odd sports celebrity or movie star, endures to have any sort of non-emergent treatment, depending on the number of specialists in any given field and geographic location, and the demand for their services...

...whereas some citizens of the world get to have all that, America gets to have meaningless, semantically-dependent non-benefits like "choice" and "no wait times".

Well, no, of course there aren't any wait times for the woman who needs cataract surgery if she can't afford it. You don't get on wait-lists for something you can't have in the first place.

Of course there is no wait time for the millions of children whose parents can't afford insurance and who thus don't get their shots or visit the pediatrician; whose prenatal care was spotty (if it existed at all); and whose nascent medical problems, presenting now, could be addressed--but aren't--instead of being ignored and permitted to worsen and develop into chronic, full-blown, infinitely costlier problems as adults.

I don't get it. I really don't. How can the richest, most powerful nation on Earth fall for this? How can we stand for this? (Emphasis, as usual, is mine.)

Cuban life expectancy in 2006 was 77.6 years, while the life expectancy of the United States for that same year was slightly less, 77.5 years (United Nations Development Program, 2006). It is interesting that poor Cuba with a history of poverty before their 1959 socialist revolution, and a devastating U.S. imposed economic blockade since, is able to provide good healthcare for everyone through socialized medicine. Cuba, unlike the United States, does not let people die in the emergency rooms without treatment, turn sick people away from receiving healthcare because they lack insurance, or allow insurance companies to decide, based on profit motive, whether the insured actually receive the care they paid for and need. The Cubans have done this by taking the profit out of illness and injury and providing healthcare as a basic human right.

Canada, like Cuba, has a higher life expectancy than the United States. In 2004 the life expectancy of Canada hit 80.2 years (Statistics Canada, 2004). With Canada’s socialized health insurance system, like Cuba’s socialized medical system, every single person is covered. In the United States 45.8 million Americans do not have health insurance (U.S. Department of Health and human Services, 2005).

On another key indicator of health, infant mortality, the United States is also nearly the worst in the developed world, only worse than the recently turned capitalist country of Latvia (Green, 2006). The infant mortality rate in the United States in 2002 was 7.0 deaths before the age of one per every 1,000 live births (Center for Disease Control, 2005). In comparison, other advanced countries with forms of socialized medicine and socialized health insurance have lower infant mortality. This includes rates per thousand births in Japan of 3.2, Germany with 4.4, Italy with 4.5, France with 4.6, and the United Kingdom with 5.6 (Treasury Board of Canada, 2003).

Cuba, with their system of socialized medicine has an infant mortality rate of 6.2 per thousand live births, a rate much lower the United States rate of 7.0 per every thousand live births (BBC News, 2002). This is also lower than every other Latin American country (BBC News, 2002).

The only other country in the Americas with an infant mortality lower than Cuba is Canada with their system of socialized health insurance. The Canadian infant mortality rate in the year 2000 was 5.3 (Treasury Board of Canada, 2003).

In addition, a United Nations report on the status of Native Americans in Canada has credited Canada’s relatively recently established socialized health insurance system with drastically reducing an extremely high infant mortality among Native Americans (United Nations, 1993). In 1979, that death rate for Canadian Native Americans was 27.6 per thousand live births, but by 1999 it had dropped to 8.0 deaths per thousand live births (Treasury Board of Canada, 2003). These improvements coincide with Canada’s passage of the Canada Health Act in 1984 that brought their socialized insurance system to the entire country at that time (Health Canada, 2002).

For Blacks in the United States between 1995 and 2002, the infant mortality rate was 13.9, more than double the rate of 5.9 for whites in the same time period (Center for Disease Control, 2005). Canadian statistics are a strong indication that a socialized insurance system in the United States could both decrease the infant mortality rate of the general population and dramatically decrease the infant mortality of oppressed and impoverished minorities such as Blacks, as it did for Canadian Native Americans.

The statistics show that socialized medicine is cheaper, saves lives, and helps alleviate class and racial inequalities in healthcare.

Give America health care, Congress, or you'll in effect be giving us death.

[*Free, in this context, means that instead of lavishing most of our tax dollars on the madcap, quaintly inefficient, legendarily-bloated, deathmongering shadow government known as the Defense Industry, we instead direct some of that cash toward buying America a chance at redeeming ourselves as thinking, feeling, moral human beings.]

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About the author

Born in England and educated there, as well as in Barbados, Honduras, and the United States. Received a Bachelor's from the University of Florida College of Journalism and Communications in 1981. Co-author, with Linda Lindroth, of the book Virtual Vintage: The Insider's Guide to Buying and Selling Fashion Online, Random House, 2002. Created the blog litbrit in 2006. Lives with her husband, three sons, and several large and loyal attack dogs and trained-assassin felines, in sunny Florida, USA.